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ObjectiveTo observe the influence of Bupi Yishen decoction on the curative effect of diabetic kidney disease rats and the tubuloglomerular feedback. MethodAmong the 100 SD male rats， 25 were randomly selected as the normal group， and the remaining 75 were treated with high-fat and high-sugar diet combined with intraperitoneal injection of low-dose streptozotocin （STZ） to establish diabetic rat model. The model rats were randomly divided into model group， Bupi Yishen group and losartan group. Bupi Yishen group and Losartan group were given Bupi Yishen decoction （23.4 g·kg-1） and losartan tablet （9 mg·kg-1）， respectively by gavage， and normal group and model group received equal volume of distilled water via intragastric administration. The treatment lasted for 11 consecutive weeks. Random blood glucose was measured once every two weeks. Rats in each group were put into metabolic cage and 24-hour urine volume was recorded. At the end of week 11， the rats were sacrificed for index detection. Enzyme linked immunosorbent assay （ELISA） was used to determine the quantification of 24-hour urinary microalbumin excretion rate （24 h UAER）， renal tubular injury-related proteins and urine creatinine. Blood was collected for creatinine and urea nitrogen detection. Hematoxylin-eosin （HE） staining， periodic acid-schiff （PAS） staining and Masson staining were performed to observe the pathological changes of the kidney of rats. The expression of sodium-glucose cotransporter 1 （SGLT1）， sodium-glucose cotransporter 2 （SGLT2）， sodium-potassium-chloride cotransporter 2 （NKCC2） and connexin 40 （CX40） was detected by immunohistochemistry. The location of adenosine type Ⅰ receptor （A1AR） in kidney was observed by immunofluorescence. In addition， the expression of SGLT1， SGLT2， NKCC2， CX40 and A1AR in renal tissues was determined by Western blot and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）. ResultCompared with normal group， renal pathology in model group showed increased glomerular volume， thickened basement membrane， and shed renal tubule epithelial cells. Compared with the model group， the renal pathology of bupiyishen group was improved. Compared with normal group， random blood glucose at different time points， 24 h UAER and renal tubule-injury-related proteins were increased in model group （P<0.01）， and the expressions of SGLT1 and SGLT2 in renal tissue were increased （P<0.01）， and the expression of NKCC2， CX40 and A1AR decreased （P<0.01）. Compared with the model group， the random blood glucose， 24 h UAER and renal tubular injury-related proteins in Bupi Yishen group decreased （P<0.01）， the expressions of SGLT1 and SGLT2 were down-regulated， and the expressions of NKCC2， CX40 and A1AR were increased （P<0.05）. ConclusionBupi Yishen decoction can improve glomerular and renal tubular injury and alleviate early hyperfiltration in diabetic kidney disease rats. The intervention effect of Bupi Yishen decoction on diabetic kidney disease is related to the regulation of tubuloglomerular feedback.
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Objective:To investigate the effects of Yishen Decoction via colonic dialysis on intestinal flora and microinflammation in patients with chronic kidney disease (CKD) stages 3-5. Methods:A total of 156 patients with stage 3-5 CKD from the Second Affiliated Hospital of Guizhou University of Chinese medicine from October 2019 to October 2020 who met the inclusion criteria were divided into 2 groups of 78 patients according to the random number table method. The control group was given colonic dialysis treatment, the treatment group was given Yishen Decoction transcolonic dialysis treatment on the basis of the control group, and both groups were treated for 8 weeks. TCM syndrome scores were performed before and after treatment, serum levels of CRP, IL-6, and TNF-α were measured by ELISA, and SCR, BUN, and uric acid (UA) levels were detected by a fully automated biochemical analyzer. Fresh feces were collected from the patients, anaerobic culture and aerobic culture were performed, and the numbers of Bifidobacterium, Lactobacillus acidophilus, and Escherichia coli were counted to evaluate the clinical efficacy. Results:The total effective rate was 97.4% (76/78) in the treatment group and 84.6% (66/78) in the control group, and the difference was statistically significant ( χ2=7.847, P=0.005). At 4 and 8 weeks after treatment, the scores of lumbar and knee tenderness( t=6.596, 8.792), eating less and being dull ( t=12.060, 24.140) and pale complexion ( t=7.983, 12.300) in the treatment group were significantly lower than those in the control group ( P<0.01); the levels of bifidobacterium ( t=4.037, 2.358) and Lactobacillus acidophilus ( t=7.352, 2.092) were significantly higher than those in the control group, while the levels of Escherichia coli ( t=3.822, 6.084) were significantly lower than those in the control group ( P<0.01 or P<0.05). The serum CRP ( t=9.326, 12.300), IL-6 ( t=4.591, 4.716), TNF-α ( t=9.304, 9.775), SCr ( t=17.630, 11.530), BUN ( t=2.674, 2.248), UA ( t=10.860, 13.160) were significantly lower than those in the control group ( P<0.01 or P<0.05). Conclusion:Yishen Decoction can improve intestinal microecological status, inhibit microinflammatory response and relieve clinical symptoms for the patients with stage 3-5 CKD.
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OBJECTIVE@#To explore the effect of Qinghuang Powder (QHP,()combined with Bupi Yishen Decoction (BPYS, ) on myelodysplastic syndromes (MDS) patients with refractory cytopenia with multilineage dysplasia (RCMD) and determine the change of DNA methylation in MDS-RCMD patients after the treatment of Chinese medicine formula.@*METHODS@#All 308 MDS-RCMD patients were treated with QHP combined with BPYS for 2 months at least, absolute neutrophil count (ANC), hemoglobin (Hb), platelets (PLT), primitive bone marrow cells and chromosome karyotype were chosen as the main evaluation indexes to analyze the treatment effect according to criteria from the MDS International Working Group. Then 43 bone marrow samples from 15 MDS-RCMD patients and 28 healthy donors were obtained for the examination of DNA methylation. Gene Ontology (GO) and Pathway analysis were applied to analyze the methylation data.@*RESULTS@#The overall MDS response rate to QHP was 61.68% (190/360) including hematologic improvement-neutrophil (HI-N) or hematologic improvement-erythroid (HI-E) or hematologic improvement-platelet (HI-P). Patients with anemia had a better response rate than patients with neutropenia or thrombocypenia (55.88% vs 31.54% or 55.88% vs. 36.9%). The DNA methylation microarray analysis disclosed that 4,257 hypermethylated genes were demethylated upon the treatment with QHP and BPYS. GO analysis and Pathway analysis showed that these demethylated genes were involved in a lot of tumor-related pathways and functions.@*CONCLUSIONS@#QHP combined with BPYS could effectively treat MDS-RCMD patients through hematologic improvement (HI-N, HI-P or HI-E) and PLT and RBC transfusion independence due to the demethylation, thereby providing another choice for the treatment of patients with MDS-RCMD.
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Female , Humans , Male , Middle Aged , Arsenicals , Pharmacology , Therapeutic Uses , Cell Lineage , DNA Methylation , Demethylation , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Gene Ontology , Leukocyte Disorders , Drug Therapy , Genetics , Powders , Treatment OutcomeABSTRACT
Objective@#To evaluate the effect of Danqi Yishen decoction on diabetes mellitus(DM) and its influence on proteinuria.@*Methods@#150 DM patients were randomly selected, and they were randomly divided into two groups according to the digital table, 75 cases in each group.The control group was given western medicine, the study group was treated by Danqi Yishen decoction.The treatment efficacy, blood serum creatinine(Cr), 24h urine protein, blood urea nitrogen(BUN) and fasting blood glucose(FBG) before and after treatment were compared between the two groups.@*Results@#The total effective rate of the study group was 84.0%, which was significantly higher than 71.1% of the control group, the difference between the two groups was statistically significant (χ2=7.215, P<0.05). Before treatment, there were no statistically significant differences in the health indicators between the two groups (all P>0.05). After treatment, the improvement of indicators of the study group were significantly higher than those of the control group (all P<0.05). After treatment, the FBG, postprandial 2h plasma glucose and fasting insulin concentration in the study group were significantly lower than those in the control group (all P<0.05).@*Conclusion@#Danqi Yishen decoction has ideal clinical effect in the treatment of DM, and can significantly reduce the proteinuria and FBG, which is worthy of widely popularized.
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AIM To investigate the effect and mechanism of Qigui Yishen Decoction (QGYS,Astragali Radix,Angelicae sinensis Radix,Chuanxiong Rhizoma,Achyranthis bidentatae Radix) on regulating the expression of miR-141 in unilateral ureteral obstruction (UUO) mice with renal fibrosis.METHODS Thirty Balb/c male mice randomly divided into sham-operated group (n =6),UUO group (n =6),Lotensin (50 g/kg) group (n =6),QGYS high dose (50 g/kg) group (n =6),and QGYS low dose (10 g/kg) group (n =6) were conducted UUO surgery to promote kidney fibrosis except the six mice in the sham operation group.After a successive 10-day medication of QGYS and Lotensin to mice by oral gavage on daily basis,all mice were killed to procure renal tissue to observe its morphology and pathology changes by HE staining.The expressions of TGF-β1,ColⅣ,and MMP-9 were analyzed by immunohistochemical method,and the expressions of miR141,TGF-β1 were measured by real-time PCR.RESULTS The obviously pathological injuries including renal interstitial fibrosis were identified by HE staining among the groups intervened with UUO,but the variance in the extent due to different administrations of QGYS and Lotensin was noticed as well (P ＜ 0.05).As compared to the UUO group,high and low dose QGYS groups and Lotensin group achieved an up-regulated expression of TGF-β1 and ColⅣ,and a down-regulated expression of MMP-9 by immunohistochemistry (P ＜ 0.05),and significantly increased Mrna expression of miR-141,and decreased Mrna expression of TGF-β1 by real-time PCR (P ＜ 0.05).CONCLUSION In UUO mouse models,QGYS gives influence to TGF-β1and MMP-9 through inducing miR-141 expression change to decrease abnormal accumulation of ECM,and thus inhibits the progression of renal fibrosis.
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Objective To evaluate the efficacy of Yangsheng-Yishen decoction combined with irbesartan in the treatment of early diabetic nephropathy (DN).Methods A total of 95 patients with early DN who met the inclusion criteria were randomly divided into control group (47 cases) and treatment group (48 cases).The control group was treated with irbesartan,while the treatment group was given Yangsheng-Yishen decoction on the basis of the control group.The two groups were treated for 6 months.The FBG,HbAlc,urinary albumin excretion rate (UAER),Scr,TG,TC,LDL-C and HDL-C were detected by automatic biochemical analyzer.The level of vascular endothelial growth factor (VEGF),platelet derived growth factor (PDGF),tumor necrosis TNF-α and transforming growth TGF-β were measured by elisa assay,and the clinical efficacy was evaluated.Results After treatment,the levels of FBG,HbAlc,UAER and SCr in the treatment group was significantly lower than those in the control group (t=3.886,4.056,9.346,8.806,all P＜0.01).After treatment,the serum TG,TC and LDL-C of the treatment group were significantly lower than those of the control group (t=8.294,12.800,6.153,all P＜0.001),and HDL-C was significantly higher than that of the control group (t=4.293,P＜0.01).The levels of serum VEGF,PDGF,TNF-α and TGF-β in the treatment group was significantly lower than those in the control group (t=13.585,11.613,10.774,10.490 respectively,all P＜0.01).Conclusions The Yangsheng-Yishen decoction combined with irbesartan can reduce blood sugar,blood lipid and urinary protein level in early DN patients,improve renal function.
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Objective To observe the effects of modified Jianpi Yishen Decoction on urinary osteopontin (OPN) in calcium oxalate nephrolithiasis patients after percutaneous nephrolithotomy (PCNL) or ureteroscope lithotomy (URL);To clarify the mechanism of modified Jianpi Yishen Decoction on the prevention of calcium oxalate kidney stones. Methods Totally 116 calcium oxalate nephrolithiasis patients were randomly divided into trial group (62 cases) and control group (54 cases). The trial group took modified Jianpi Yishen Decoction every other day, while the control group took potassium sodium hydrogen citrate granules three times a day. The concentrations of OPN, urinary calcium and urinary oxalic acid of the patients in the two groups were observed before treatment and 2 weeks and 4 weeks of treatment. Results The concentration of urinary OPN of 2 weeks and 4 weeks of the treatment in the trial group was significantly increased compared with before treatment (P0.05). The differences in the concentrations of urinary calcium and urinary oxalic acid of the two groups between before and after treatment were not significant (P>0.05). Conclusion Modified Jianpi Yishen Decoction can effectively restrain the formation of the calcium oxalate stones by increasing the level of urinary OPN, which demonstrates effective prevention in the calcium oxalate nephrolithiasis patients after PCNL or URL.
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Objective To investigate the specific expression of endoplasmic reticulum stress-related GRP78 and CHOP in podocyte of MKR mice with diabetic nephropathy (DN);To discuss the intervention effect of Zuogui Jiangtang Yishen Decoction (ZGJTYS). Methods 8-week old MKR mice were randomly divided into five groups:blank group, model group, ZGJTYS group, 4-Phenylbutyric acid group, gliquidone+benazepril group, and normal control group consisting of wild type C57BC/6 mice, 10 mice per group. All mice from model group and each treatment group received high-fat diet feed and unilateral nephrectomy to make the DN model. Mice from treatment groups received medicine intervention for four weeks. The levels of FBG were detected by electrochemical detection method, and the UmAlb was detected by ELISA. The expressions of GRP78, CHOP mRNA, and protein were detected by RT-PCR and Western blot. The morphological structure changes of the podocytes were observed by transmission electron microscopes. Results Compared with blank group, FBG and UmAlb in the model group increased significantly (P<0.01);the expressions of GRP78 mRNA and protein markedly decreased (P<0.01);the expressions of CHOP mRNA and protein increased (P<0.01). Compared with the model group, FBG and UmAlb in each treatment group significantly decreased (P<0.01);the expressions of GRP78 mRNA and protein in the ZGJTYS group and 4-Phenylbutyric acid group increased (P<0.01), the expressions of CHOP mRNA and protein decreased (P<0.01). The renal pathological lesions of each treatment group were significantly improved compared with model group. Conclusion ZGJTYS Decoction can effectively improve the damaged podocyte induced by endoplasmic reticulum stress, delay DN progress.
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Objective To investigate the effects of Zuogui Jiangtang Yishen decoction (ZGJTYS) on the expression of nephrin and podocin in podocyte of MKR mice with diabetic nephropathy (DN), and explore its mechanism. Methods Forty MKR mice (8 weeks old) were randomly divided into four groups as follows:negative control group (group A), DN model group (group B), ZGJTYS group (group C) and positive control group (group D, Gliquidone and benazepri). All mice from group B, C and D were received high-fat diet feed and unilateral nephrectomy. Four weeks after operation, all mice were received drug intervention, and four weeks later, all mice were put to death. The levels of UmAlb were observed by ELISA, the serum BUN and Cr by biochemical, and the FBG by electrochemical detection method. The nephrin and podocin mRNA expression were measured by RT-PCR and the protein expression by western blotting. The morphological structure changes of the podocytes were observed by transmission electron microscopes. Results As compared with group A, FBG, BUN, SCr and urine UmAlb in the mice of group B increased significantly (P<0.01), the expression level of nephrin and podocin mRNA and protein were markedly decreased (P<0.01). After intervention of drugs, all biochemical indicators above in the mice of group C and D significantly decreased (P<0.01), the expression level of nephrin and podocin mRNA and protein were markedly increased (P<0.01, P<0.05), compared with group B. The renal pathological lesions of group C and D were significantly improved compared with group B. Conclusion ZGJTYS decoction exerts reno-protective effect via reinstating nephrin and podocin expression to repair the damaged podocyte.
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Objective To investigate the effect and safety of Huoxue Yishen Decoction and Western medicine in treatment of chronic glomerulonephritis,in order to provide the basis for clinical diagnosis and treatment.Methods 67 cases with chronic glomerulonephritis admitted in People's hospital of Lanxi City from September 2012 to November 2013 were randomly divided into control group (n=32)and treatment group (n=35). The control group were given dipyridamole tablets,fosinopril sodium tablets,anti-infection and other symptomatic treatment and water electrolyte and acid-base balance disorders were corrected.Observation group were added Huoxue Yishen Decoction on the basis of control group treatment.A course of treatment was 4 weeks and all patients were treated for 2 courses. Results After treatment,the symptom score in treatment group (9.34 ±4.27 )was significantly lower than control group(13.35 ±5.64),and the difference was statistically significant (P<0.05).24 h protein,SCr and BUN in treatment group were significantly lower than control group,and the difference was statistically significant (P<0.05 ).The total effective rate of treatment group (91.43%)was significantly higher than control group(28.12%),the difference was statistically significant (P<0.05).Conclusion Huoxue Yishen Decoction combined with Western medicine in treatment of chronic glomerulonephritis can significantly improve renal function,it is effective and safety and has important value in clinical research.
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Objective To observe the effect of Yishen Decoction in treating IgA nephrotic massive albuminuria.Methods 44 cases of IeA nephropathy massive albuminuria are randomized into a treatment group and a control group.The control group is give.conventional western medical treatment,and the treatment group is given Yishen Decoction on the basis of conventional western medical treatment.Both groups are treated for a therapeutic period of 6 months.Observe the indexes of urine protein,serum creatinine(Scr),and blood urea nitrogen(BUN)24 hours before and after the treatment.Results The total efficiency of the treatment group and the control group is 86.36%,and 54.55%respectively.There is significant difference between the two groups.Besides,the treatment group is better at reducing albuminuria and protecting renal function than the control group.Conclusion Yishen Decoction is good at treating IgA nephrofic albuminuria.